"Reparative" and "Conversion" Therapies for Lesbians and Gay Men
by: National Committee on Lesbian, Gay, and Bisexual Issues, NASW
January 21, 2000
"When generally recognized standards do not exist with respect
to an emerging area of practice, social workers should exercise careful judgment
and take responsible steps (including appropriate education, research, training,
consultation, and supervision) to ensure the competence of their work and to
protect the clients from harm" (NASW, 1996).
The social worker should not practice, condone, facilitate,
or collaborate with any form of discrimination on the basis of . . . sexual
orientation . . ." (NASW, 1996)
What are "reparative" or "conversion"
Reparative or conversion therapies claim, through
the use of psychotherapy or other interventions, to eliminate a person’s sexual
desire for a member of his or her own gender. The National Association of Social
Workers’ National Committee on Lesbian, Gay, and Bisexual Issues (NCLGB)
recognizes the emergence of these misleading therapies. Reparative and
conversion therapies, sometimes called "transformational ministries," have
received wider attention against the backdrop of a growing conservative
religious political climate (NASW, 1992), and through recent media campaigns
supported by the Christian Coalition and the Family Research Council. By
advancing their efforts through such propaganda, proponents of reparative and
conversion therapies, such as the most commonly cited group NARTH, claim that
their processes are supported by scientific data; however, such scientific
support is replete with confounded research methodologies (Mills, 1999).
What are sexual orientation, sexual identity, and sexual behavior?
Sexual orientation is defined by the sex of individuals for
whom one feels an attraction and affection, both physical and emotional. Sexual orientation includes "sexual activity with members of one’s own
sex (homosexual orientation), the opposite sex (heterosexual orientation), or
both (bisexual orientation)" (Barker, 1999, pp. 439–440). Moreover, sexual
orientation differs from other mistakenly ascribed concepts, such as sexual
identity and sexual behavior. Sexual identity refers to a person’s
self-perception of his or her sexual orientation, and sexual behavior refers to a person’s sexual activities. In an effort to understand human
relationships and human sexuality, "social workers must be knowledgeable about
biological factors, as well as about the roles played by psychological,
cultural, and social factors in sexual expressions" (Harrison, 1995, p.
Can therapy change sexual orientation?
People seek mental health services for many reasons.
Accordingly, it is fair to assert that lesbians and gay men seek therapy for the
same reasons that heterosexual people do. However, the increase in media
campaigns, often coupled with coercive messages from family and community
members, has created an environment in which lesbians and gay men often are
pressured to seek reparative or conversion therapies, which cannot and will
not change sexual orientation. Aligned with the American Psychological
Association’s (1997) position, NCLGB believes that such treatment potentially
can lead to severe emotional damage. Specifically, transformational ministries
are fueled by stigmatization of lesbians and gay men, which in turn produces the
social climate that pressures some people to seek change in sexual orientation
(Haldeman, 1994). No data demonstrate that reparative or conversion therapies
are effective, and in fact they may be harmful (Davison, 1991; Haldeman,
Why is this issue relevant to the social work
Social workers should have a broad-based knowledge about human
sexuality, human sexual development across the life cycle, a high degree of
comfort and skill in communicating and responding to such issues, and a
knowledge of appropriate community services (Harrison, 1995). Social workers
across fields of practice, including foster care, mental health, corrections,
substance abuse, school social work, and prevention education, may encounter
lesbian and gay clients. The literature indicates that "interventative
therapies" that attempt to alter sexual orientation of lesbians and gay men have
succeeded only in reducing sexual behavior and self-esteem rather than shaping
attractions of opposite gender (Haldman, 1994).
What are the value and ethical implications for social
NCLGB asserts that conversion and reparative therapies are an
infringement to the guiding principles inherent to social worker ethics and
values. This belief is affirmed by the NASW policy statement on "Lesbian, Gay,
and Bisexual Issues" (1996). In discussing ethical decisions for social work
practice, Loewenberg and Dolgoff (1996) noted, "the priority of professional
intervention at the individual level will be to help people achieve
self-actualization, rather than helping them to learn how to adjust to the
existing social order" (p. 47). The NASW Code of Ethics enunciates
principles that address ethical decision making in social work practice with
lesbians, gay men, and bisexual people—for example, social workers’ commitment
to clients’ self-determination and competence, to achieving cultural competence
and understanding social diversity, and to clients who lack decision-making
capacity; social workers’ ethical responsibilities to colleagues, their
commitment to interdisciplinary collaboration, and their responsibility to
report unethical conduct of colleagues; social workers’ ethical responsibilities
as professionals—maintaining competence, fighting discrimination, and avoiding
misrepresentation; social workers’ ethical responsibilities to the social work
profession, to evaluation, and to research.
How can I practice the nondiscrimination tenets of my
A social worker may apply techniques that may cause
considerable harm and anguish for a client while reinforcing the existing
prejudice and homophobia that gay men and lesbians experience daily. The use of
these therapies deny the viability of same-gender relationships as fulfilling
and natural; many lesbians and gay men in such arrangements report significant
satisfaction and contentment. Social workers need to be aware of the scripted
attitudes toward lesbians and gay men (NASW, 1992). As first asserted in the
original NCGLB reparative therapy position statement (1992), "If a client is
uncomfortable about his/her sexual orientation, the sources of discomfort must
be explored, but without prior assumption that same-sex attraction is
dysfunctional" (pp. 1, 2). Social workers are obligated to use nonjudgmental
attitudes and to encourage nurturing practice environments for lesbians, gay
men, and bisexuals. NASW discourages social workers from providing treatments
designed to change sexual orientation or from referring clients to practitioners
or programs that claim to do so (NASW, 1992).
What can social workers do?
NASW’s policy statement on lesbian, gay, and bisexual issues
can be viewed as a "blueprint" for social work’s role in addressing the concerns
and strengths of gay, lesbian, and bisexual clients and communities both within
and outside the profession. The policy states, "NASW supports legislation,
regulation, policies, judicial review, political action, and changes in social
work policy statements and the NASW Code of Ethics (1996), and any
other means necessary to establish and protect the equal rights of all people
without regard to sexual orientation" (p. 202).
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Authored by the National Committee on Lesbian, Gay, and Bisexual
Issues. Adopted by the NASW Board of Directors, January 21, 2000.